“This is a problem for our health-care system. It doesn’t put great value on care that takes time to pay off. But this is also an opportunity. We have the chance to transform the course of our lives.” — Excerpt from “The Heroism of Incremental Care” by Atul Gawande
In a 2011 article for The New Yorker, surgeon and public-health researcher Atul Gawande examines the idea of incremental care. The basis of this approach is rooted in the idea that a healthcare approach which practices patience, and focuses on provider-patient relationships, drives positive health outcomes.
In his piece, Gawande shares a story about a patient named Bill Haynes, who struggled with chronic migraines for decades before meeting with a headache specialist who methodically worked with him on a treatment plan that improved his migraines over the course of five years. Gawande notes, “Success, therefore, is not about the episodic, momentary victories, though they do play a role. It is about the longer view of incremental steps that produce sustained progress.”
Better Care Through Better Relationships
After spending time observing patients at a colleague’s primary care clinic, Gawande realized another key component of effective primary care. “Studies have established that having a regular source of medical care, from a doctor who knows you, has a powerful effect on your willingness to seek care for severe symptoms,” writes Gawande.
Vera Whole Health's approach mirrors Gawande’s argument for incremental care. Vera’s time-rich appointments, empathetic listening models, and dedicated care teams create the sort of relationships that make incremental care possible. “We devote vast resources to intensive, one-off procedures, while starving the kind of steady, intimate care that often helps people more,” writes Gawande.
He noted that the efficacy of providers at the clinic he observed was largely dependent on their long history with those patients. Over years, they had developed relationships with their patients that allowed them to create treatment plans that reflected that personal, in-depth knowledge of the patient’s health and background. In turn, patients felt so comfortable with their providers that they didn’t hesitate to come in for an appointment. That ease and familiarity resulted in better health management.
On-Site Clinics Create Better Relationships
Vera's on-site clinics develop the same environment Gawande lauds in his research on incremental care. Because care is easily accessible, patients are more likely to utilize clinic services. When they arrive, empathetic listening practices encourage discussions about a patient's barriers and goals for better health. Afterward, health coaches guide them toward better health by helping them set realistic goals.
It's a process that empowers patients to take ownership of their health and to utilize the help of their provider and health coach. Over time, these relationships drive positive health outcomes because everyone involved is invested and dedicated to the same goals.